Incisions for abdominal and pelvic surgery may be minimized by laparoscopic surgery in which, rather than a long incision, various smaller openings are provided by a plurality of "nails" into the abdominal area, with a sheath being provided around the "nail" to maintain the opening when the "nail" is withdrawn. Various other instruments may then be inserted through the opening in the sheath, such as lasers, forceps, and fiber-optic cameras for viewing the areas.
It is, however, difficult at times to obtain suitable access to some operative sites without providing an increased number of abdominal puncture sites. Gaining access by increasing the number of abdominal entry sites can produce intra-abdominal clashing of the instruments and increase operative difficulty.
Also, in laser surgery there is a danger that the laser will make not only the desired incision but also cut healthy tissue behind the incision. One method which has been used to prevent this where possible has been to provide a backing structure (which will not reflect the laser beam) beneath the tissue being cut and above the healthy tissue. Even with a backing structure, however, it can be difficult to provide a laser cut at right angles to the tissue (as is desirable), and it is also difficult to ensure that the incision is straight rather than jagged. Further, with multiple incisions (particularly when incisions are made in tubular body components, such as during salpingostomy procedures), it is often difficult to consistently provide the desired uniform spacing between incisions.
Still further, the blood vessels which are adjacent laser cuts are frequently not small enough to allow the laser to provide effective hemostatis, and therefore there is often undesirable bleeding at the incision.
The present invention is directed toward overcoming one or more of the problems as set forth above.